Sir, having read both the editorial (BDJ 2004, 196: 375) and then the review article by Wilson and Banerjee (BDJ 2004, 196: 395) it seemed to me that the questions posed by the editor may have some relevance to dentists trying to make sense of occlusion and the retruded contact position.

It is no fault of the authors of the paper that they had to contend with a subject full of contradictory opinions, and also one that has been so badly taught in the UK for so long. However it was their choice.

The reader of the article might have no clear message on how to further the clinical practise of occlusion. Having met many dentists in general practice it is my firm belief that most qualified dentists have no clear notion of how to deal with occlusion, articulators and reorganising an occlusion, and who can blame them either.

In America, those wishing to study occlusion have no shortage of gurus to follow. When you combine the American flair for explanations together with an appetite for excellence at all costs (particularly where a commercial angle can be found), occlusion starts to make sense.

Newer concepts and well-made systems of equipment can truly allow the experienced dentist to begin occlusal registration and conservative treatments.

I notice, as an example, that the review makes no reference to Dr Robert Lee and a lifetime of pioneering work on the subject. I also notice that only in the last page is a fleeting reference to any type of splint therapy made, but with no details. Many contemporary experts in the field of occlusion support the concept of the most superior anterior position of the condyles as a reproducable and comfortably stable position to record.

A temporary deprogramming splint is frequently used to help break neuro muscular attitudes. The Bioesthetic splint is one device I have real experience in using. The MAGO (Maxillary Anterior Guided Orthotic) is just one example of a modern attempt to aid identification and then recording of a stable condylar position. Rather than complain about the shortcomings of a review article, which can do no more than collect a selection of previous publications, I would ask both the editor and the authors what kind of paper would best help dentists really understand more about occlusion.